April 04, 2019, Kitchener, Ontario
Posted by: Robert Deutschmann, Personal Injury Lawyer
CanChild has released new guidelines for children and youth recovering from concussion. The guidelines remain more conservative for children than for adults in recognition of the fact that children’s brains are under developed and to help prevent subsequent concussion during the recovery period. The McMaster University research institute developed the guidelines.
CBC news has reported that
"For children, recovering from a concussion is like a snakes and ladders game, as there are times where they may have rapid improvement and climb through the steps more quickly, and other times where returning symptoms mean they have to take a slide back," said author Carol DeMatteo, professor of rehabilitation science and a CanChild researcher, in a statement.
"Families have always felt the recovery instructions were too restrictive and difficult to follow. We now know that too much rest after concussion is not a good thing, and children can begin some activity sooner as long as they don't overdo it and make their symptoms worse."
DeMatteo said the updated guidelines suggest that during the first 24 hours after the injury, at home and leisure activities can be undertaken as long as they are in five-minute chunks, and stopped if symptoms increase.
The research centre says its new guidelines branch out into three categories of concussions, for people who are symptom free within 48 hours, one to four weeks, or for people who have symptoms for more than a month, respectively.
Recovery is broken into stages, which outline a goal, activities allowed and what to look for before heading to the next stage.
She said the most important thing for people to remember is every child is different and will progress at their own pace based on the severity of their symptoms.
DeMatteo said that among Canadian children, the average age for a sport-related concussion is 13.5-years-old, and both in Hamilton and across Canada, the most common sports resulting in concussions for boys is hockey, and for girls is soccer.
And the news release from the Canchild website reads:
Safely Returning Children and Youth to Activity after mTBI/Concussion
The decision regarding return to activity following Mild Traumatic Brain Injury (mTBI)/concussion is one of the most difficult and controversial areas in concussion management for adults and even more complicated for children and youth. Children who sustain a mTBI are being provided with management strategies and return to activity guidelines that have been designed for adult athletes.
This population is at high risk for repeat injuries within a short period of time as well as prolonged symptoms affecting their school and leisure participation and success. Experts agree that return to activity (RTA) including Return to School (RTS) decision should be more conservative, cautious, and individualized for children and youth. Our clinical and research team at McMaster Children's Hospital and CanChild have developed, with CIHR funding, new RTA and RTS guidelines as part of a study to educate family physicians about mTBI in children.
The current study evaluates these innovative, recently developed, evidenced-based guidelines with children and families. Outcomes include: time to symptom resolution, repeat injuries, length of time to return to play and school and parents' and children's perception of the new guidelines. Electronic activity monitoring devices as well as applications for symptom monitoring will be used to provide both compliance with guidelines and health information. In order to understand how children with different symptom resolution differ biologically, we will incorporate new EEG techniques never used with children with mTBI. We will also trial a method of exertion testing having children pedal an ergometer while in the MRI scanner to look for effects of exercise on the injured brain.
The issue of returning to activity after mTBI is very important to the children and families of Canada. Protecting the brains of our children through increased knowledge and decision-making based on sound research is paramount.